Left Ventricular Longitudinal and Circumferential Layer‐Specific Myocardial Strains and Their Determinants in Healthy Subjects

Shi, Jing; Pan, Cuizhen; Kong, Dehong; Cheng, Leilei; Shu, Xianhong

doi:10.1111/echo.13132

Cited by 76 publications

(73 citation statements)

References 20 publications

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“…An increased epicardial-to-endocardial gradient of LS were described from the basal to the apical level of the ventricle in pregnant women, which is in agreement with the findings of layer-specific LS in normal non-pregnant subjects [7, 9]. We noticed that the deformation of three-layer myocardium at the basal level was significantly different in the second and the third trimester, while it was almost homogenous in the early pregnancy and postpartum as well as non-pregnant controls.…”

Section: Discussionsupporting

confidence: 83%

“…Until recently, speckle tracking echocardiography (STE) has been upgraded, which allows to quantify myocardial function in three layers [6]. Layer-specific differences of myocardial performance and deformation have been analyzed in normal subjects and different heart diseases [6–9]. However, still little is known about how differently multilayer myocardium contributes to myocardial deformation throughout the progress of normal pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative evaluation of longitudinal strain in layer-specific myocardium during normal pregnancy in China

Cong

Wang

Jin³

et al. 2016

Cardiovasc Ultrasound

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BackgroundThe myocardial wall of the left ventricle is a complex, multilayered structure and is not homogenous. The aim of this study was to determine longitudinal strain (LS) in the three myocardial layers in normal pregnant women according to gestation proceedings.MethodsThe advanced two-dimensional speckle tracking echocardiography (2D STE) was performed on 62 women during each pregnancy trimester and 6 to 9 weeks after delivery, while 30 age-matched, healthy, nonpregnant women served as controls. LS on endocardial, mid-myocardial and epicardial layers at 18 cardiac segments were measured.ResultsAs gestation proceeded, all of layer-specific LS and global LS progressively decreased, which subsequently recovered postpartum (P < 0.05), and the LS gradient between inner and outer myocardium became greater, which reached its maximum in the late pregnancy. Peak systolic LS was the highest at endocardium and the lowest at epicardium, while the highest at the apical level and the lowest at the base (P < 0.05). In the early pregnancy and postpartum, LS at basal level was homogenous, meanwhile layer-specific LS showed significant differences at mid-ventricular and apical level throughout the progress of normal pregnancy (P < 0.05).ConclusionsUsing 2D STE, three-layer assessment of LS can be performed in pregnant women and shall give us new insights into the quantitative analysis of global and regional LV function during pregnancy. Future studies on the detection of pregnancy related heart disease would require these parameters as reference values for each time point of a normal pregnancy.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Quantitative evaluation of longitudinal strain in layer-specific myocardium during normal pregnancy in China

Cong

Wang

Jin³

et al. 2016

Cardiovasc Ultrasound

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“…It is possible that the transmural gradient may be a unique parameter of myocardial diseases. In an echocardiography-based study, transmural strain gradient was established as a new parameter to evaluate wall motion, and was considered to be a more robust parameter of strain than global strain34. Therefore, in the present study, a parameter named G epi-endo in Ecc was also calculated, which showed an interesting association with age.…”

Section: Discussionmentioning

confidence: 96%

Distribution pattern of left-ventricular myocardial strain analyzed by a cine MRI based deformation registration algorithm in healthy Chinese volunteers

Liu

Yang

Wan

et al. 2017

Sci Rep

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The cine magnetic resonance imaging based technique feature tracking-cardiac magnetic resonance (FT-CMR) is emerging as a novel, simple and robust method to evaluate myocardial strain. We investigated the distribution characteristics of left-ventricular myocardial strain using a novel cine MRI based deformation registration algorithm (DRA) in a cohort of healthy Chinese subjects. A total of 130 healthy Chinese subjects were enrolled. Three components of orthogonal strain (radial, circumferential, longitudinal) of the left ventricle were analyzed using DRA on steady-state free precession cine sequence images. A distinct transmural circumferential strain gradient was observed in the left ventricle that showed universal increment from the epicardial to endocardial myocardial wall (epiwall: −15.4 ± 1.9%; midwall: −18.8 ± 2.0%; endowall: −22.3 ± 2.3%, P < 0.001). Longitudinal strain showed a similar trend from epicardial to endocardial layers (epiwall: −16.0 ± 2.9%; midwall: −15.6 ± 2.7%; endowall: −14.8 ± 2.4%, P < 0.001), but radial strain had a very heterogeneous distribution and variation. In the longitudinal direction from the base to the apex of the left ventricle, there was a trend of decreasing peak systolic longitudinal strain (basal: −23.3 ± 4.6%; mid: −13.7 ± 7.3%; apical: −13.2 ± 5.5%; P < 0.001). In conclusion, there are distinct distribution patterns of circumferential and longitudinal strain within the left ventricle in healthy Chinese subjects. These distribution patterns of strain may provide unique profiles for further study in different types of myocardial disease.

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“…In addition, the endocardial layer moves toward the chambers of the heart, its movement range is larger than the range of the epicardial layer which is still in a relatively static condition during the myocardial systolic phase, which causes different local stresses in each layer . Some studies of GLS and GCS by layer‐specific 2DSTE on healthy people had similar gradient characteristics …”

Section: Discussionmentioning

confidence: 99%

Early assessment of the left ventricular function by epirubicin‐induced cardiotoxicity in postoperative breast cancer patients

et al. 2017

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Left Ventricular Longitudinal and Circumferential Layer‐Specific Myocardial Strains and Their Determinants in Healthy Subjects

Abstract: Three-layer analysis of longitudinal and circumferential strain using two-dimensional speckle tracking imaging (2DSTI) can be performed on a clinical basis and may become an important method for the assessment of real time, quantitative global, and regional LV function.

Cited by 76 publications

References 20 publications

Quantitative evaluation of longitudinal strain in layer-specific myocardium during normal pregnancy in China

Quantitative evaluation of longitudinal strain in layer-specific myocardium during normal pregnancy in China

Distribution pattern of left-ventricular myocardial strain analyzed by a cine MRI based deformation registration algorithm in healthy Chinese volunteers

Early assessment of the left ventricular function by epirubicin‐induced cardiotoxicity in postoperative breast cancer patients

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